16-100125a ._ I •
City of Federal way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
0
Electrical
Permit #: 16 -100125 -00 -EL
Project Name: BUTKO
Project Address: �'R 15:9:308TH ST C ICI IT)
Project Description: Replace outlets & switches; add arc -fault breakers.
Inspection Request Line: (253) 835-3050
Parcel Number: 785360 0005
Owner
li n
Contractor
AIB LLC
MASON ELECTRIC
MASON ELECTRIC
PO BOX 3266
PO BOX 2491
MASONE*876JZ (4/10/17)
FEDERAL WAY WA
BELFAIR WA 98528
PO BOX 2491
98063
BELFAIR WA 98528
Additional Permit Information
Electrical Work Valuation?....................................1000 Is this an Online or O.T.C. application? ................. Yes
Is Use Educational or Institutional?.......................No
Electrical Fixtures
Circuits - Residential ...................... 3
PERMIT EXPIRES Saturday, July 9, 2016
Permit Issued on Monday, January 11, 2016
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way. Owner or agent:��� Date: % -11-//
a
a
CITY OF
Federal Way
PERMIT #:
Project:
16 -100125 -00 -EL
AS LLC
THIS CARD IS TOAIN ON-SITE -
Construction In ection Record
INSPECTION REQUE TS: (253) 835-3050
Address: 1916 S 308TH ST
FEDERAL WAY, WA 98003-4821
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible{read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
E]
UFER Ground (4295)
Ditch cover (4030)
Temporary Power (4275)
Slab/Concrete Floor (4255)
Approved
By
Approved
Approved to place concrete
By
Date
By
Date
By
Date
0 Final - Electrical (4055)
Approved
By �� Date ,1 —0a
El
Rough Electrical
Approved
Temporary Power (4275)
Service (4235)
By
Pool Bonding (4195)
Approved
Date
Approved
Date
Approved
By
Date
By
Date
By
Date
E]
E
Ceiling Cover (4020)
Rough Electrical (4225)
Feeders/Sub-panels (4045)
Approved
Approved
I
Approved
By
Date
By
Date
By
Date
0 Final - Electrical (4055)
Approved
By �� Date ,1 —0a
El
Rough Electrical
Approved
Final Electrical
Approved
Right of Way
Approved
By
Date
By
Date
By
Date
CITY OF VAS
Federal Way
RECEIVED
JAN 112016
CITY OF FEDERAL WAY
CDS
ELECTRICAL
PERMIT APPLICATION
PERMIT NUMBER _ o V- S CS L
SITE ADDRESS: S l: o � '
SUITE/UNIT/SPACE #
PROJECT / V��TGO
ASSESSOR'S TAX/PARCEL # � �
3 � � �
CURRENT/PROPOSED USE
_
�
PROJECT NAME
(Tenant or Homeowner Last Name)
S' )4-
l R-1 1
-'
PROJECT DESCRIPTIONev-
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME
0�G1L Lel }��CU(-)
PRIMARY PHONE
G� ,77
MAILING ADDRESS
E-MAIL
CITY r>
STATE
ZIP
FAX
c%
VIA
( ) -
NAME
PRIMARY PHONE
MAILING ADDRESSy
p (� C� ZI/
EMAIL
�'l1 �� elegy Z5� G�li 1
ELECTRICAL
CONTRACTOR
CITY
&lam,°,r-s
STATE
ZIP
FAX Co :n
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
* 7GS
FEDERAL WAY BUSINESS LICENSE #
lv1u50iV,E
NAMES
" " "" i /l G�
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
EMAIL
coxy/
CITY ^ L J
ATEA
ZIP 0 i
FAR
PROJECT CONTACT
NAME I J
CC,-
PRIMARY PHONE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental Iaws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as apart of this application.
SIGNATURE:
PRINT NAME:
Bulletin # 160 —January 1, 2013 Page 1 of 2 k:\Handouts\Electrical Permit Application